ABSTRACT
Background: Accurate diagnosis of heart failure (HF) is essential for its proper management and logical drug therapy to reduce morbidity and mortality. On this perspective researcher are in search of a good biomarker as complementary to the clinical parameters to improve the performance of HF diagnosis. B-type natriuretic peptide (BNP) secreted by cardiac ventricles in HF has emerged as a new promising biomarker in this regard. Objective: To evaluate the performance of plasma BNP as a diagnostic biomarker in HF. Methods: In a cross sectional study 180 clinically suspected HF patients were selected. Their plasma BNP were measured and then subjected to echocardiogram. Patients were categorized as HF and without HF on the basis of echocardiogram and against this information the performance of plasma BNP of study subjects were evaluated as a diagnostic biomarker of HF considering 100 pg/ ml as its cut off point. Results: Sensitivity, specificity, accuracy, PPV, NPV, PLR and NLR of plasma BNP for diagnosis of HF found to be 88 %, 63.8 %, 77.2 %, 75.2 %, 81.0 %, 2.4 and 0.2 respectively. Conclusion: Plasma BNP concentration increases in HF. Based on 100 pg/ml as cut off point, plasma BNP shows good performance in diagnosis of HF.
ABSTRACT
Background: Accurate diagnosis and clinical staging of heart failure (HF) is essential for its proper management and logical drug therapy to reduce morbidity and mortality. On this perspective researcher are in search of a good biomarker as complementary to the clinical parameters to improve the performance of HF diagnosis and its clinical staging. B-type natriuretic peptide (BNP) secreted by cardiac ventricles in HF has emerged as a new promising biomarker in this regard. Objective of the study was evaluation of plasma BNP concentration in relation to the severity of HF and its use as a biomarker for clinical staging of HF. Methods: In a cross sectional study 100 HF cases diagnosed by clinical parameters and echocardiography were enrolled and sub grouped into NYHA classes (I, II, II & IV) depending on clinical severity and functional limitations. Plasma BNP measured in all study subjects and summarized in each of these sub groups. Results: Median plasma BNP concentration in NYHA class-I, II, III & IV found to be 82.7, 267.2, 694.8 & 1530.4pg/ml respectively with progressive rising trend and at 95% CI level the plasma BNP in different sub groups were 64.5-112.7, 214.3-293.5, 626.4-902.4 & 1443.1-2384.4pg/ml respectively. Conclusion: Plasma BNP concentration increases progressively with increasing severity of HF to make it to be used for clinical staging of the disease. In mild, moderate and severe HF plasma BNP proposed to be 100-460, 460-1170 and >1170pg/ml respectively.